Trends and ethnic disparities in the incidence and outcome of stroke in Auckland, New Zealand over 20 years

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dc.contributor.advisor Prof. Craig Anderson en
dc.contributor.author Carter, Kristie Norah en
dc.date.accessioned 2008-02-19T01:44:45Z en
dc.date.available 2008-02-19T01:44:45Z en
dc.date.issued 2007 en
dc.identifier.citation Thesis (PhD--Clinical Trials Research Unit)--University of Auckland, 2007. en
dc.identifier.uri http://hdl.handle.net/2292/2365 en
dc.description.abstract Aims: The aims of this thesis were to investigate trends and ethnic disparities in the incidence and outcome of stroke in Auckland, New Zealand between 1981 and 2003. Methods: Trends were assessed using information from the three Auckland Regional Community Stroke (ARCOS) studies, conducted in people (aged ≥15 years) in Auckland, during 12-month calendar periods in 1981-1982, 1991-1992, and 2001-2002. These studies used comparable definitions and case finding methods and have been shown to meet the stringent criteria for a population-based “ideal” stroke incidence study. Rates were calculated using Poisson distribution and are presented with 95% confidence intervals. Trends in survival were assessed using Cox Proportional hazards regression modelling. Results: Overall trends in the incidence and event rates of stroke declined across the study period. These declines were significant in males and for the ages 65 to 74 years only. However, growing disparities in the rates of stroke between the major ethnic groups in New Zealand were found, with significant declines in New Zealand Europeans and increases in Māori and Pacific populations. Dramatic improvements in survival over the study period were also found, with the greatest improvement in the acute period, within the first 28-days after stroke. Adjustments for patient or disease severity factors strengthened the survival model. However, adjustments for care/service factors nullified the survival model, thus explaining most of the improving trend. Conclusions: The small declines in the incidence of stroke, improvements in survival and the ageing of the New Zealand population will lead to data dramatic increases in the number of people living with the effects of stroke. To maintain stable numbers of strokes occurring, more intensive prevention strategies need to target high-risk populations and population-wide health education strategies are needed to improve the health of the general population, hence reducing the risk of stroke. en
dc.description.sponsorship Health Research Council (HRC) of New Zealand Pacific Health PhD scholarship en
dc.language.iso en en
dc.publisher ResearchSpace@Auckland en
dc.relation.ispartof PhD Thesis - University of Auckland en
dc.relation.isreferencedby UoA1775167 en
dc.rights Items in ResearchSpace are protected by copyright, with all rights reserved, unless otherwise indicated. en
dc.rights.uri https://researchspace.auckland.ac.nz/docs/uoa-docs/rights.htm en
dc.subject Stroke en
dc.subject Epidemiology en
dc.subject Ethnic disparities en
dc.subject Incidence en
dc.subject Survival en
dc.title Trends and ethnic disparities in the incidence and outcome of stroke in Auckland, New Zealand over 20 years en
dc.type Thesis en
thesis.degree.discipline Clinical Trials Research Unit. en
thesis.degree.grantor The University of Auckland en
thesis.degree.level Doctoral en
thesis.degree.name PhD en
dc.subject.marsden Fields of Research::320000 Medical and Health Sciences en
dc.rights.holder Copyright: The author en
pubs.local.anzsrc 11 - Medical and Health Sciences en
pubs.org-id Faculty of Medical & Hlth Sci en


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